Prenatal and childhood origin of an adult disease; The case of breast cancer Gabriel Gulis SDU Esbjerg, Denmark Anna Pakosova Trnava University, Trnava,

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SYNOPSIS OF THE PROTOCOL

Presentation transcript:

Prenatal and childhood origin of an adult disease; The case of breast cancer Gabriel Gulis SDU Esbjerg, Denmark Anna Pakosova Trnava University, Trnava, Slovakia

Breast cancer mortality

Breast cancer morbidity

Major risk factors Hormonal risks (menarche, parity, menopause) Lifestyle (diet, alcohol, smoking, physical exercise) Medications (oral contraceptives, HRT) Genetic predisposition Early life risk factors

birthweight birth length gestational age at birth twin, zygosity age of mother at delivery weight and height of mother in/out of pregnancy birth order

What data are available in Slovakia Presentation of data and data soruces available in Slovakia on early life risk factors Data sources: birthbook birthregistry medical record

Data from Birthbook Birthweight/birthlength twin, zygosity gestational age at birth age of mother at delivery birth order

Data of birth registry Birthweight/birth length twin, zygosity gestational age at birth age of mother at delivery birth order *data from birth registry are available since 1959

Data from Medical record Birthweight/birth length twin, zygosity age of mother at delivery birth order weight/height of mother at different ages age at menarche age at menopause

Data from Medical record Use of oral contraceptives use of hormone contraceptives alcohol smoking

Changes of data sources over time

Description of Slovak study - methodology Prospective, hospital based case-control study Trnava region, Trnava and Skalica district hospitals 3 years, 250 cases and controls Newly diagnosed histologically confirmed cases, if possible at the beginning of treatment Age and region matched controls by frequency matching

Description of Slovak study – practical performance Key collaborators in hospitals are head nurses, good collaboration with heads of oncology departments as well

Possibilities for intervention Based on study we expect to bring new field for breast cancer prevention among adolescents: Increase information campaigns in schools Breast cancer awareness programs, risk factors, determinants Involvment of pediatricians

Summary Work in progress, first experiences Interest of clinicians from hospitals is crucial High willingness of cases to participate Implications for intervention

Acknowledgement: The authors acknowledge a grant number R03 TW of Fogarty Center of NIH, USA which made the study possible